[Skip to Content]
[Skip to Content Landing]
Article
August 1995

A Comparison of Driving in Older Subjects With and Without Age-Related Macular Degeneration

Author Affiliations

From the Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago Eye Center, University of Illinois at Chicago College of Medicine (Drs Szlyk, Pizzimenti, and Fishman and Messrs Kagan and Ho); Department of Research and Development, West Side Veterans Administration Medical Center, Chicago (Drs Szlyk, Pizzimenti, and Wetzel and Mr Ho); and Department of Physical Medicine and Rehabilitation, Hines (Ill) Veterans Administration Hospital (Mr Kelsch).

Arch Ophthalmol. 1995;113(8):1033-1040. doi:10.1001/archopht.1995.01100080085033
Abstract

Objective:  To determine the effects of age and central vision loss on driving skills.

Methods:  Ten subjects with age-related macular degeneration and average binocular visual acuity of 20/70, and 11 age-similar subjects with normal vision, were examined with a battery of cognitive and visual tests, an interactive driving simulator, and an on-road driving test. Data were collected on the frequency of real-world accidents and convictions for traffic violations.

Results:  There were no significant differences between the two groups on any of the cognitive tests. The age-related macular degeneration group demonstrated poorer performance on the driving simulator, including delayed braking response times to stop signs, slower speeds, and more of both lane boundary crossings and simulator accidents. The age-related macular degeneration group also demonstrated poorer overall on-road test performance, including having significantly more points deducted for driving too slowly and for not maintaining proper lane position. However, these effects on the simulator and the on-road test did not translate into an increased risk of real-world accidents for the age-related macular degeneration group. Significantly more control subjects than patients with age-related macular degeneration were involved in self-reported accidents, and significantly more control subjects had state convictions for traffic violations. There was evidence of compensation in the age-related macular degeneration group in four major areas: (1) not driving in unfamiliar areas; (2) traveling at slow speeds; (3) self-restricting their nighttime driving, and (4) taking fewer risks while driving (eg, not changing lanes). There was also evidence of compensation in the older control group.

Conclusions:  Vision, simulator, and on-road test variables combined with subjective risk taking predicted self-reported real-world accidents in a logistic regression analysis. However, risk taking, rather than simulator or road-test performance, was the most significant predictor for both patients with age-related macular degeneration and the control group.

×